Home Drugs Suboxone


Suboxone, a two-drug medication containing buprenorphine and naloxone, chemically decreases an individual’s dependence on opioid medications and alleviates the severity of withdrawal symptoms. The brain believes it’s receiving an opioid but has a block against the euphoric effects of the drug.

Last Modified: June 12, 2024
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What Is Suboxone?

Suboxone contains a 4:1 ratio of buprenorphine HCl and naloxone HCl dihydrate. Suboxone is the brand name for the sublingual film. Subutex and Zubsolv are common brand names for the tablet formulation. Both formulations have generic options. The medication assists individuals with managing cravings for opioids and symptoms of withdrawal.

With sublingual administration, an uncoated hexagon-shaped orange tablet or sublingual film dissolves quickly under the tongue. Quick absorption in the body means people receive higher drug levels in the bloodstream.

Key Facts
  • Suboxone has a much lower risk of creating dependency than methadone.
  • A prescription is required.
  • The drug usually takes effect within 20 to 45 minutes.

Because the body absorbs Suboxone quickly, individuals find the medication can quickly treat their symptoms. Since the drug doesn’t go through the digestive system, people can generally take a lower dose without compromising its effectiveness.

How Does Suboxone Work?

Two active substances in Suboxone both mimic and counter the effects of taking an opioid. Buprenorphine is a partial opioid agonist that acts like an opioid, whereas naloxone is an opioid antagonist that counteracts the effects. Naloxone discourages inappropriate use since the medication leads to withdrawal symptoms if misused.

Though the combination of medications may seem counteractive, it is the effect on the brain that creates the benefit. Unlike full opioid agonists, such as oxycodone, partial opioid agonists, including buprenorphine, satisfy the opioid receptors in the brain without fully activating them, which results in reduced withdrawal effects and euphoric feelings.

Dosage Information

People usually take Suboxone under the tongue in a single daily dose. Depending on the person, the dosage could range from 8 to 24 milligrams a day and can last in the system for several days.

If you miss a dose, take the medication as soon as you remember, unless it’s close to time for the next dose. In this case, skip the missed dose and resume taking it at your normally scheduled time.

Dosage Strengths
Buprenorphine 2mgNaloxone 0.5mg
Buprenorphine 4mgNaloxone 1mg
Buprenorphine 8mgNaloxone 2mg
Buprenorphine 12mgNaloxone 3mg

If you’re unsure of your dosing, contact your health care provider. Individuals need to be careful of excess or overdosing. Contact Poison Control or seek emergency medical help right away if you take too much Suboxone.

Common Side Effects of Suboxone

Many of the more common side effects of Suboxone are mild and don’t have a lasting impact. The severity of discomfort depends on the individual and dosage.

Mild Adverse Side Effects
  • Back pain
  • Blurred vision
  • Burning mouth syndrome
  • Constipation
  • Difficulty falling asleep or staying asleep
  • Excessive sweating
  • Headache
  • Lesions in the mouth
  • Mouth numbness or redness
  • Nausea
  • Stomach pain
  • Swelling in the extremities
  • Symptoms of withdrawal
  • Tongue pain
  • Vomiting

In clinical trials, higher doses of medication led to higher reporting of side effects in patients. Users should contact their doctor if they experience any of these concerns.

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Serious Suboxone Side Effects

The safety label on Suboxone warns of potentially serious side effects, including agitation, fatigue and pain. Drinking alcohol or taking Suboxone along with over-the-counter medications that contain alcohol increases the risk of serious reactions, as can taking it with other narcotics or abusing the prescription.

Severe Adverse Reactions
  • Agitation, confusion, slurred speech and hallucinations
  • Allergic reactions that include swelling in the throat, face, tongue or lips; itching; rash or hives
  • Blurred vision
  • Dark-colored urine
  • Decreased sexual desire
  • Difficulty breathing or swallowing
  • Digestive distress with nausea, vomiting, diarrhea or loss of appetite
  • Extreme tiredness, lack of energy, weakness or dizziness
  • Fast heartbeat, shivering, fever and sweating
  • Inability to get or keep an erection
  • Irregular menstruation
  • Light-colored stools
  • Loss of coordination, muscle stiffness or twitching
  • Pain in the upper right part of the stomach
  • Unusual bruising or bleeding
  • Yellowing of the eyes or skin

Though generally considered safe for reducing dependence on opioids, this drug’s possible side effects can be harmful to some individuals. Suboxone’s packaging also contains a number of safety warnings.

Suboxone Warnings and Precautions

Warnings for Suboxone range from caution about dependency and allergic reactions to possible medical complications. Individuals taking the drug should be aware of all published warnings and precautions.

Important Suboxone Warnings
  • Adrenal insufficiency: This is when the adrenal glands don't produce enough of the hormone cortisol.
  • Allergic reaction: An allergic response may include wheezing, facial swelling, hives or a rash, low blood pressure and a loss of consciousness in severe cases.
  • Central nervous system depression: CNS depression is a severe reduction in the activity of the nervous system controlling the major body processes.
  • Dental injury: There are reports that continuous use leads to tooth decay, low saliva levels and oral infections.
  • Dependence: Answering whether Suboxone is addictive, long-term use can lead to dependency when regularly taken.
  • Head injury: The drug can cause increased pressure or swelling in the brain, adversely affecting those with prior head trauma or brain injuries.
  • Hepatitis risk: Some studies show elevated liver enzymes in those who use Suboxone, potentially leading to inflammation and damage of the liver.
  • Impaired abilities: As a central nervous system depressant, using the drug can lead to reduced reaction times and slow reflexes, creating difficulties when driving, operating machinery and cognitive functioning.
  • Neonatal Opioid Withdrawal Syndrome: Subozone use during pregnancy can cause the opioid to cross through the placenta to a fetus, create dependency on opioids and lead to severe withdrawal symptoms at birth.
  • Respiratory depression: Individuals may experience an increase in their heart rate, slow shallow breathing, shortness of breath or frequent yawns.

For safe prescription drug use, talk to your doctor about any medical conditions you have or medications you’re taking. The risks depend on the length of use and dosage.

Breathing Problems and Suboxone

Hypoventilation is the most serious adverse effect associated with Suboxone use. There is potential for hypoxic brain injury or death from oxygen restriction to the brain and its cells.

This risk can be minimized when patients follow dosing protocols. High doses of Suboxone or mixing the drug with medication increases the potential for life-threatening breathing problems.

FDA Warns About Suboxone Dental Injuries

In 2022, the U.S. Food and Drug Administration issued a warning that Suboxone could lead to dental problems. Commonly reported problems include oral infections, cavities, tooth decay and loss of teeth. These concerns are serious and possible even when there is no history of dental issues.

The acidic nature of Suboxone and its extended placement in the mouth led to the safety warning statement. The FDA advises users and prescribers to strategize ways to improve oral health while using the drug.

Suboxone Dental Injuries Lead to Lawsuits

Many individuals prescribed Suboxone film experienced serious dental injuries. Because of the severity of their injuries, many are now filing suit against Suboxone’s manufacturers.

Those injured say the film led to tooth loss, tooth and gum injuries, cavities, tooth decay and tooth fractures. One of the Suboxone lawsuits lists Indivior Inc., Indivior PLC and Indivior Solutions Inc. as defendants.

Alternatives to Suboxone

Behavioral therapy, mental health therapy and medications provide alternatives to Suboxone. It’s important to follow through with your prescribed medications until speaking to a doctor. Rather than stopping Suboxone abruptly, your physician may recommend a step-down approach to a new treatment.

Suboxone Alternatives
  • Extended-release Vivitrol
  • Lifestyle changes
  • Methadone
  • Psychological counseling including cognitive behavior therapy

While Suboxone provides a way to reduce dependence on opioids, there are alternative treatments available. Discuss your options with your physician.

Please seek the advice of a medical professional before making health care decisions.